Adult ADHD prescribing patterns are being reshaped by stimulant supply normalisation

Reading the signal

Adult ADHD diagnosis and treatment expanded substantially through the late 2010s and early 2020s, driven by improved recognition of adult presentation, expanded prescriber comfort, and increased patient-initiated care-seeking. The stimulant supply shortages from 2022 onward exposed how rapidly demand had grown:

• Manufacturing capacity for the class had been sized to historical demand levels and had not scaled with the new utilisation
• Patients faced material access disruption during the shortage period, with switching to alternative formulations or to non-stimulant alternatives, with treatment interruption, or with discontinuation entirely
• The DEA quota system in the United States and equivalent regulatory mechanisms in other markets compounded the supply constraints

Manufacturing capacity has caught up through 2025 and into 2026. Prescribing patterns are now stabilising:

• Initiation rates have stabilised at substantially higher absolute levels than pre-shortage
• Patient retention has improved as the supply environment normalises
• The eligible-population picture is structurally larger than the historical level represented; whether utilisation will continue to grow at the pre-shortage rate, plateau at current levels, or normalise to a different equilibrium is genuinely open

Commercial implications

For sponsors of established stimulant assets, non-stimulant ADHD assets, and adjacent psychiatric pipeline:

1. The commercial baseline has reset. Models that anchor on pre-shortage utilisation systematically underestimate the current and projected eligible population
2. Non-stimulant alternatives (atomoxetine, viloxazine, alpha-2 agonists, novel mechanisms in development) gained share during the shortage. Whether they retain that share post-normalisation is the live commercial question
3. Adjacent indications (binge eating disorder, narcolepsy, novel ADHD subtypes) face the same supply-and-access landscape and benefit from the lessons of the past three years

What we are watching

• Net prescribing data across stimulant and non-stimulant classes and the rate of share normalisation
• Late-stage non-stimulant ADHD pipeline and the positioning conversation as the supply environment normalises
• Adjacent indication readouts and how they engage with the reshaped commercial landscape